Urine cytology is a non-invasive diagnostic method for detecting and monitoring bladder cancer, based on the collection of voided urine to examine exfoliated epithelial cells on glass slides. Follow-up tests, such as immunocytochemistry (ICC) and fluorescence in-situ hybridization (FISH), are also carried out using standard glass slides. However, hematuria is one of the most common presenting symptoms with bladder cancer, and both cytology and slide-based diagnostic testing can be confounded by the presence of red blood cells and inflammatory cells. Cytology slides prepared from specimens containing a high concentration of obscuring blood cells often lead to non-diagnostic results that necessitate repeat testing, unnecessary cystoscopy, and in some cases, exploratory biopsies. In all cases, these unnecessary procedures place a significant financial burden on both the patient and the healthcare facility. Although methods are available for processing specimens to concentrate urothelial cells and remove obscuring cell types, these methods are expensive, time-consuming, disruptive to cell phenotype, or all of the above.
Fine-needle aspiration (FNA) cytology is the standard technique for evaluating thyroid nodules. Hemorrhaging is common during the procedure, however, leading to an aspirate that is diluted by blood. Subsequent slide preparations are often suboptimal, resulting in nondiagnostic outcomes that necessitate additional testing or diagnostic surgery. In fact, quality is so unpredictable that a pathologist must often be present in the operating room to certify that the slides are adequate, thus adding substantial cost and complexity to the procedure. Furthermore, even with an optimal slide preparation, cytology yields indeterminate results up to 30% of the time. In the absence of a conclusive diagnosis, most indeterminate patients are guided towards an often unnecessary partial or near-total thyroidectomy. Immunocytochemistry and fluorescence in-situ hybridization are useful tools for diagnosing indeterminate cases, but such tests are not usually carried out on existing smears due to a paucity of follicular cells and an abundance of red blood cells. As a result, additional slides must be prepared using expensive and time-consuming techniques. Thus, there is a significant need for increasing the capture and isolation of follicular cells on FNA slide preparations, in addition to facilitating the development of ancillary diagnostic tests for categorizing indeterminate results.
The presently disclosed subject matter provides compositions and methods to address the above described needs and limitations of current healthcare practices.